Prevalence of Malnutrition in People with Dementia in Long-Term Care: A Systematic Review and Meta-Analysis

Abstract

Dementia is a common syndrome in older people. Dementia alters eating behaviors, hunger and thirst cues, swallow function, ability to self-feed, and recognition and interest in food. There is significant variation in the reported prevalence of malnutrition among older people who live in long-term care. The aim was to conduct a systematic literature review and meta-analysis of the prevalence of malnutrition in those with dementia living in long-term care using a validated nutrition assessment tool. Scopus, Web of Science, CINAHL, and Medline were searched. A random effects model was used to determine the prevalence and risk of malnutrition. Data were retrieved from 24 studies. Most of the studies were from Europe or South Asia. The prevalence of malnutrition ranged from 6.8 to 75.6%, and the risk of malnutrition was 36.5–90.4%. The pooled prevalence of malnutrition in those with dementia in long-term care was 26.98% (95% CI 22.0–32.26, p < 0.0001, I2 = 94.12%). The pooled prevalence of the risk of malnutrition in those with dementia was 57.43% (95% CI 49.39–65.28, p < 0.0001, I2 = 97.38%). Malnutrition is widespread in those with dementia living in long-term care. Further research exploring malnutrition in other industrialized countries using validated assessment tools is required.

An Assessment of Physical Activity and Risk Factors in People Living with Dementia: Findings from a Cross-Sectional Study in a Long-Term Care Facility in Vietnam

“…PWD may experience a loss of their capacity to perceive their own hunger and thirst signals, an inability to feed themselves, a lack of interest or avoidance of food, difficulty in identifying familiar objects and perplexity, and dependence on others for aid with eating and swallowing (dysphagia), eventually leading to advanced dementia [ 65 ]. As dementia progresses, the need for assisted living increases due to the behavioral and psychological changes that occur, such as walking without purpose, worsening cognitive impairment, and difficulties in independently engaging in ADL [ 66 ]. Furthermore, malnutrition resulting in the loss of skeletal muscle mass increases stagnation and weakness, and reduces physical exercise [ 67 ].…”

Feasibility of Oral Function Evaluation According to Dementia Severity in Older Adults with Alzheimer’s Disease

“…A particular issue in patients with dementia in long-term care is that malnutrition is often observed. The results of meta-analyses including studies of regions in Europe or South Asia pooled the prevalence of malnutrition in this population at 57% [5]. This suggests that nutritional management is particularly important in planning care for patients with dementia.…”

“…Evaluation of oral function, including eating and swallowing abilities, in patients with dementia is important for determining appropriate and practical dietary support plans. Oral function has been shown to be related to nutritional intake [5,6], food forms [7,8], and nutritional status [9,10]. A study conducted in nursing home residents worldwide aged ≥65 years from Europe and North America reported an association between the presence of dysphagia, evaluated using responses of nursing homes staff and nutritional intake [6].…”

Barriers and facilitators to dementia care in long-term care facilities: protocol for a qualitative systematic review and meta-synthesis

“… 10 However,there is still a gap between the theory and practice of dementia care in long-term care facilities. Studies suggest that the quality of life of people with demnetia in facilities still needs to be improved, 11 and that feeding difficulties, 12 pain management 13 and other disease-related care needs require further attention. Besides, behavioural and psychological symptoms are common in people with dementia, and how to manage these symptoms is still an endeavour.…”